Reimbursement Request Form definition
Examples of Reimbursement Request Form in a sentence
When you elect to have your designated vendor administer your Account-Based Offerings, Blue Cross and Blue Shield will provide services in accordance with the Claim Reimbursement Request Form you provide to Blue Cross and Blue Shield for services under this Account-Based Offerings Administrative Services Agreement.
This Account-Based Offerings Administrative Services Agreement will be considered accepted and binding by the parties when you sign your Group Setup Form or, when applicable, your Claim Reimbursement Request Form, or you pay your first month’s service fees for Account-Based Offerings.
When you elect to have Blue Cross and Blue Shield work with your designated vendor for your Account-Based Offerings, you will provide Blue Cross and Blue Shield with a completed Claim Reimbursement Request Form that designates certain aspects of the Account-Based Offerings that you will make available to your eligible employees.
Blue Cross and Blue Shield will administer these services in accordance with the terms and conditions of this Account-Based Offerings Administrative Services Agreement, your Group Setup Form and Fee Schedule or, when applicable, your Claim Reimbursement Request Form and Fee Schedule, and the Business Associate Agreement which is included as Attachment 3 to the Premium Account Agreement.
When you elect to have Blue Cross and Blue Shield work with your designated vendor for your Account-Based Offerings, Blue Cross and Blue Shield will provide services as described in this Account-Based Offerings Administrative Services Agreement and in your Claim Reimbursement Request Form.
The Superintendent will sign the SMCPS Tuition Reimbursement Request Form, indicating approval or denial, and return the signed form to the employee within ten workdays of its receipt in the Department of Human Resources.
Documentation must be submitted with a completed Grant Funding Assistance Reimbursement Request Form.
Additional Project Funds will be promptly disbursed to the Recipient upon receipt of Reimbursement Request Form 260 and Form 261, or any amendment thereto, duly completed and executed by the Recipient for incurred costs consistent with this Agreement, along with receipt of progress reports due under this Agreement.
The Training Funds Reimbursement Request Form can be found at ▇▇▇▇▇://▇▇▇▇▇▇▇▇▇▇▇▇.▇▇.▇▇▇/lhd/ under the General Information: Training Reimbursement section.
Employees must complete a City of ▇▇▇▇▇▇ Island AFSCME Uniform Employee Reimbursement Request Form with approval by the employee's supervisor and Department Director prior to reimbursement.